The Effect of Body Mass Index on the Feasibility of Surgery and Prognosis of Colorectal Cancer Patients Over 80 Years Old

Abstract

Objective This study aimed to evaluate the safety and feasibility of radical surgery and explore prognostic factors affecting cancer-specific survival (CSS) in colorectal cancer (CRC) patients over 80 years old.Methods From January 2010 to December 2020, a total of 372 elderly CRC patients who underwent curative resection at the National Cancer Center were enrolled and classified into a control group (BMI <24 kg/m2) and an overweight group (BMI ≥24 kg/m2). Preoperative clinical features, perioperative outcomes and postoperative pathological characteristics were collected and compared between the two groups.Results The control group and overweight group comprised 219 and 153 patients, respectively. There was no significant difference between the two groups of patients in terms of operative time (153.0 vs 142.3 min, P=0.226), intraoperative bleeding (67.8 vs 69.3 ml, P=0.873) or other surgical outcomes or grade 3-4 postoperative complications (11.1% vs 14.6%, P=0.326). The 5-year CCS of patients in the overweight group was significantly worse than that of the control group (63.3% vs 80.0%, P=0.046). The multivariate analysis showed that CCS was significantly affected by BMI (HR: 2.30; 95% CI, 1.27-4.17; P=0.046) and N stage (HR: 2.97; 95% CI, 1.48-5.97; P=0.002)Conclusion The results of this study demonstrated that radical resection for CRC is safe and feasible for patients over 80 years of age. The increase in BMI does not increase the difficulty of surgery or postoperative complications. BMI and N stage were independent prognostic factors for elderly CRC patients after radical resection.